Does Weekend Discharge Affect Readmission and Survival in Liver Transplant Patients? Insights From a Cohort Study.

作者信息

Obana Ayato, Akabane Miho, Chi Hannah, Ladd Nolan, Yoder Matthew, Kaufman Lily, Punjala Rithin, Shah Kejal, Hamilton Matthew, Limkemann Ashley, Schenk Austin, Singh Navdeep, Slyvester Black, Mumtaz Khalid, Washburn Kenneth, Alebrahim Musab

机构信息

Department of Surgery, Comprehensive Transplant Center, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

出版信息

Clin Transplant. 2025 Jan;39(1):e70081. doi: 10.1111/ctr.70081.

BACKGROUND

Weekend hospital discharges are often associated with reduced staffing, potentially impacting the quality of patient care. We studied the effects of weekend discharge after liver transplantation (LT) on early readmission rates, overall survival (OS), and graft survival (GS).

METHOD

We analyzed data from the Ohio State University Wexner Medical Center database (January 2016 to December 2023). The study included initial LT recipients (LTRs) including donation after brain death (DBD) and donation after cardiac death (DCD). Primary outcomes encompassed early readmission rates, and secondary outcomes included OS and GS.

RESULTS

The cohort comprised 915 LTRs (645 DBD, 270 DCD), with 156 (17.0%) weekend and 759 (83.0%) weekday discharges. Regarding discharge disposition, 681 (74.4%) patients were discharged home, 210 (22.9%) were discharged to healthcare facilities. No significant differences were identified in the length of hospital stay (8 days vs. 9 days, weekend vs. weekday, respectively, p = 0.22) or 30-day readmission (29.5% vs. 32.5%, weekend vs. weekday, respectively, p = 0.75). There were no significant differences in OS (90.9% vs. 92.7% at 1-year, 84.4% vs. 88.0% at 3-year, weekend vs. weekday, p = 0.27) and GS (90.9% vs. 91.5% at 1-year, 84.0% vs. 86.6% at 3-year, weekend vs. weekday, p = 0.50). Multivariate logistic analysis showed no significant impact of weekend discharge (OR: 0.84 [0.57-1.22], p = 0.35) or discharge disposition (OR: 1.00 [0.75-1.33], p = 1.00) on 30-day readmission. Multivariate Cox regression analysis found no significant impact of weekend discharge or discharge disposition on OS and GS (all p > 0.05).

CONCLUSION

Weekend discharge does not impact early readmission, OS, or GS in LTRs. These findings are a testament to our multidisciplinary team efforts and suggest that with appropriate discharge planning and follow-up care, the timing of discharge may be less critical than previously assumed.